Pseudomonas Species Bacteremia Caused by Contaminated Normal Human Serum Albumin

In May and June 1973, 11 patients on the surgical service at the University of Maryland Hospital had bacteremia caused by Pseudomonas species. Seven of the isolates recovered from blood cultures had the same antibiogram (sensitive only to chloramphenicol and tetracycline). Ten of the II patients wer...

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Bibliographic Details
Published in:The Journal of infectious diseases 1977-05, Vol.135 (5), p.729-735
Main Authors: Steere, Allen C., Tenney, James H., Mackel, Donald C., Snyder, Merrill J., Polakavetz, Sandra, Dunne, Mary E., Dixon, Richard E.
Format: Article
Language:English
Subjects:
Albumins
Bacteremia
Blood
Chloramphenicol - pharmacology
Disease outbreaks
Disease Outbreaks - prevention & control
Drug Resistance, Microbial
Epidemiologic Methods
Epidemiology
Hospital administration
Humans
Infections
Major Articles
Microbial sensitivity tests
Nalidixic Acid - pharmacology
Pseudomonas
Pseudomonas - drug effects
Pseudomonas - isolation & purification
Pseudomonas aeruginosa - drug effects
Pseudomonas aeruginosa - isolation & purification
Sepsis - etiology
Serum Albumin - standards
Serum albumins
Tetracycline - pharmacology
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Summary:In May and June 1973, 11 patients on the surgical service at the University of Maryland Hospital had bacteremia caused by Pseudomonas species. Seven of the isolates recovered from blood cultures had the same antibiogram (sensitive only to chloramphenicol and tetracycline). Ten of the II patients were given 25% normal serum albumin (human) shortly before the onset of symptoms. In contrast, only two of seven patients with bacteremia due to Pseudomonas aeruginosa in May and June (P = 0.013) and only nine of 20 patients located in surgical special care units during these months (P = 0.014) were given this product. When cultured, the albumin in one of 54 previously unopened vials from the implicated lot yielded Pseudomonas cepacia sensitive only to chloramphenicol, tetracycline, and nalidixic acid. Subsequent investigation showed that five more patients in four other hospitals had symptoms of bacteremia shortly after the infusion of different lots of albumin from the same manufacturer, and in four cases P. cepacia was cultured from the suspect albumin. Since sterility testing by manufacturers may not detect low-frequency contamination, surveillance of nosocomial infections, investigation of un usual disease clusters, and prompt reponing of suspect reactions are essential in the control of such outbreaks.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/135.5.729